alexa Spectral Doppler Waveform Analysis of Common Femoral Veins for the Detection of Right Ventricular Dysfunction in Acute Pulmonary Embolism
ISSN: 2329-9517

Journal of Cardiovascular Diseases & Diagnosis
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Research Article

Spectral Doppler Waveform Analysis of Common Femoral Veins for the Detection of Right Ventricular Dysfunction in Acute Pulmonary Embolism

Bettina-Maria Taute1*, Hendrik Schmidt2, Andreas Gunter Bach3, Ronald Fischer1, Christin Le Hoa Tran1, Mroawan Amoury4 and Hannes Melnyk1
1University Hospital of the Martin-Luther-University Halle-Wittenberg, Department of Internal Medicine III/Angiology, Ernst-Grube-Str. 40, D-06120 Halle (Saale), Germany
2Hospital Magdeburg, Clinic of Cardiology, Birkenallee 34, D-39130 Magdeburg, Germany
3University Hospital of the Martin-Luther-University Halle-Wittenberg, Department of Radiology, Ernst-Grube-Str. 40, D-06120 Halle (Saale), Germany
4University Hospital of the Martin-Luther-University Halle-Wittenberg, Emergency Department, Ernst-Grube-Str. 40, D-06120 Halle (Saale), Germany
Corresponding Author : Bettina-Maria Taute
University Hospital of the Martin-Luther-University of Halle-Wittenberg
Department of Internal Medicine III / Angiology
Ernst-Grube-Str. 40, D-06120 Halle (Saale) Germany
Tel: +49 345 557 3351
E-mail: [email protected]
Received November 12, 2014; Accepted December 29, 2014; Published December 30, 2014
Citation: Taute BM, Schmidt H, Bach AG, Fischer R, Tran CLH, et al. (2015) Spectral Doppler Waveform Analysis of Common Femoral Veins for the Detection of Right Ventricular Dysfunction in Acute Pulmonary Embolism. J Cardiovasc Dis Diagn 3:187. doi: 10.4172/2329-9517.1000187
Copyright: © 2015 Taute BM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Background Changes of central and peripheral venous hemodynamics (PVH) are registered in patients with acute pulmonary embolism (PE) with right ventricular dysfunction (RVD). It can be assumed the change of PVH is detectable through spectral Doppler waveform analysis of the common femoral veins (CFV) and regular respiratory modulated (RM) flow is replaced as a function of the severity of the RVD by cardiac modulation (CM) of the velocity-time spectra. The aim of this study is to examine, through detection of CM at the CFV, whether indirect diagnostics of the RVD is possible in patients with acute PE. Methods Quantification of RVD was performed through an echocardiographic right heart score (RHS) in patients with acute PE. The RHS integrated four parameters: the size of the right ventricle, the RV kinetics, the motion of the interventricular septum and the right atrial size. The sonographic quantification of RM and CM at the CFV was performed through measurement of the flow duration directed towards the heart in the velocity-time spectrum. The results of the RHS and the respective spectral Doppler waveform at the CFV were comparatively analysed. Results In 47 acute PE-patients CM was found in 53.2%. A RHS of 1 was present in 17% and there was no CM. CM was found in 19% of patients with a RHS of 1.25, and in 92% of patients with a RHS of 1.5. All patients with a RHS of ≥ 1.75 had a CM. The sensitivity and specificity for the CM with a cut-off RHS of 1.5 amounted to 0.96 and 0.88 respectively. Conclusion The CM at the CFV is an indirect diagnostic criterion of RVD with acute PE. In the case of suspected PE, the absence of CM excludes a RVD. Disappearance of CM during the clinical course of PE indicates improvement in RV function.

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